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Cancer-associated myositis: a single-centre 20-year experience
Vasiliki Syrmou1, Theodora Simopoulou1, Eleni Patrikiou1
1Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University General Hospital of Larissa, Viopolis, Mezourlo Hill, Larissa, 41500, Greece.
Cancer-associated myositis (CAM) affects 22% of idiopathic inflammatory myopathy (IIM) patients, often presenting asymptomatically. Early cancer screening is crucial, especially for those with anti-TIF1γ antibodies, older age, or lacking specific symptoms like Raynaud's phenomenon.
Area of Science:
- Rheumatology
- Oncology
- Immunology
Background:
- Idiopathic inflammatory myopathies (IIM) are autoimmune diseases with a known association with malignancy, termed cancer-associated myositis (CAM).
- Limited population-specific data exist regarding the prevalence and characteristics of CAM.
- Understanding CAM is crucial for early cancer detection and improved patient outcomes.
Purpose of the Study:
- To determine the prevalence, clinical features, and risk factors of cancer-associated myositis (CAM) in a Greek tertiary center over a 20-year period.
- To identify specific autoantibodies and clinical signs associated with CAM.
- To evaluate the impact of CAM on patient survival.
Main Methods:
- Retrospective analysis of 113 idiopathic inflammatory myopathy (IIM) cases treated between 2001 and 2024.
- Evaluation of medical records for demographics, clinical characteristics, autoantibody profiles, and comorbidities.
- Definition of CAM as myositis with cancer onset/recurrence within 3 years of myositis diagnosis.
Main Results:
- Cancer-associated myositis (CAM) was identified in 22.1% of patients, with breast, ovarian, and lung cancers being most common.
- Older age, dermatomyositis subtype, and anti-TIF1γ autoantibody positivity were associated with higher CAM risk.
- Malignancy was often asymptomatic (85%), detected via screening; CAM patients had significantly lower survival rates (45% at 31 months vs. 95.9%).
Conclusions:
- Cancer-associated myositis (CAM) represents a significant proportion of idiopathic inflammatory myopathy (IIM) cases.
- Anti-TIF1γ positivity, older age, and absence of specific symptoms like Raynaud's phenomenon or interstitial lung disease are potential flags for CAM.
- Comprehensive cancer screening, including GI endoscopy, is vital for initial assessment and ongoing management of IIM patients, particularly during relapses.